The Therapeutic Potential of Non-Invasive and Invasive Cerebellar Stimulation Techniques in Hereditary Ataxias
, Giorgi Batsikadze 2, Carina França 3, Rubens G. Cury 3 and Roderick P. P. W. M. Maas 4,*Round 1
Reviewer 1 Report
In this paper, the authors review the clinical and neurophysiological effects of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and dentate nucleus DBS in patients with hereditary ataxias. They also reviewed the presumed underlying mechanisms at the cellular and network level and perspectives for future research.
Over the past decade, several brain stimulation techniques, including rTMS, tDCS, and dentate nucleus DBS, have shown promise in modulating cerebellar excitability and restoring physiological activity in patients with ataxia and other neurodegenerative disorders. This is a timely review of the topic. It is also important that the authors point out further research is necessary before these techniques can be widely adopted in clinical practice.
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Reviewer 2 Report
This is a comprehensive review that discusses two cerebellar stimulation techniques as potential therapies. Some aspects must be considered about cerebellar functions that are not necessarily motor tasks. For this reason, I suggest that non-motor functions of the cerebellum be described in detail.
In the introduction, nothing about Sca 7 to add information.
At the end of section 2.2, Cellular mechanisms and network effects of tDCS, it should be concluded whether tDCS has a positive or beneficial effect.
In rows 213-215, it has been widely shown that the cerebellum is involved in cognitive functions, memory, emotions, sexual responses, language, and sensory integration, not only in motor processes. Why suggest that the cerebellum modulates cognitive and affective processes in cortical regions? If the same cerebellum is involved in these. I suggest adjusting this information and adding quotes supporting the information you presented and mentioned.
The information is ambiguous in rows 231-232, which are concerned with clinical and physiological changes.
In several sections of the manuscript, reference is made to the deep cerebral nuclei, describing in greater detail which deep nuclei are referred to.
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